I've written about health care for more than two decades, starting from my native Iowa where I covered the presidential campaign bus rides of Bill and Hillary Clinton through the Hawkeye state talking health reform and the economy. I have covered the rise, fall and rise again of health reform, chronicling national trends as well as the influence of Barack and Michelle Obama from Chicago's South Side on changes to the U.S. health system from my base in Chicago. I am the author of the new Forbes signature series book, "Inside Obamacare: The Fix For America's Ailing Health Care System." I was health care business reporter at the Chicago Tribune (1998-2011) and previously wrote for Modern Healthcare magazine when first arriving in Chicago in 1993. Prior to that, I wrote for several Iowa newspapers including the Des Moines Register. These days, I contribute stories to the New York Times, Chicago Medicine magazine and teach in the University of Iowa School of Journalism MA in Strategic Communication program. You can see me nationally on Fox News Channel's "Forbes on Fox" show. In Chicago, you can hear my health segments and business analysis on WBBM newsradio 780 and 105.9 FM. I am passionate about health literacy when it comes to explaining the complexities of health care. A better understood health system may save someone some money or their life.

Doctors Lag Far Behind On New Medicare Diagnosis Codes

Less than 5 percent of physician practices have made “significant progress” when rating their overall readiness for tens of thousands of new government-mandated “ICD-10” codes used to describe diseases and hospital procedures in the insurance billing process, a Medical Group Management Study shows.. (Image credit: AFP/Getty Images via @daylife)

Less than 5 percent of physician practice have made “significant progress” when rating their overall readiness for tens of thousands of new government-mandated “ICD-10” codes used to describe diseases and hospital procedures in the insurance billing process, a new study shows.

Though the conversion to 140,000 new codes that medical-care providers will use in order to bill government and private insurers doesn’t occur until Oct. 1, 2014, it doesn’t look like doctor practices will be ready.

New research out this week by the Medical Group Management Association shows “only 4.8 percent of practices reported that they have made significant progress when rating their overall readiness for ICD-10 implementation.” More than 1,200 medical groups representing more than 55,000 doctors were part of the research.

“It is proving to be one of the most complex and expensive changes our healthcare system has faced in decades,” said Dr. Susan Turney, president and chief executive officer of the Medical Group Management Association.

The conversion is being required by the Centers for Medicare & Medicaid Services to provide more specificity to the existing coding system. The current ICD-9 codes have limited information about medical conditions and hospital procedures while the new ICD-10 code “sets provide flexibility to accommodate future health care needs, facilitating timely electronic processing of claims by reducing requests for additional information to providers,” Marilyn Tavenner, Acting Administrator of the Centers for Medicare & Medicaid Services wrote earlier this year to the American Medical Association, which has urged a delay in implementing the new codes.

MGMA’s Turney said the transition will impact documentation of clinical care, physician productivity in how they care for patients and reimbursement to doctors from insurance companies and government payers at a time doctors are also trying to get their practices ready for electronic health records, or EHR.

“Adding to the implementation challenge and clearly taxing all stakeholders, ICD-10 will arrive at the same time that a number of other transformative federal policies go into effect, such as health insurance exchanges and Stage 2 of the (Centers for Medicare & Medicaid Services) Meaningful Use EHR Incentive Program,” Turney said.

“A successful transition to ICD-10 requires coordination between providers and their vendor, clearinghouse and health plan trading partners,” Turney said. “Our data suggest that many practices are in the dark in terms of moving forward with ICD-10 as this coordination has not yet occurred.”

MGMA, the American Medical Association and various other medical-care provider groups worry the health care industry will not be ready, saying they still have to train their office staffs, buy the right computer systems and grapple with the mountain of administrative and related changes necessary that increases the number of diagnostic codes to about 69,000 from nearly 14,000 while the number of inpatient procedure codes rises to about 87,000 from about 3,000.

“Without the necessary software changes and testing, practices will have no confidence that they will be paid for the care they deliver to their patients after Oct. 1, 2014,” Turney said.

Medicare administrator Tavenner has said there are no plans to delay or cease implementation, saying the conversion to ICD-10 was already delayed a full year from October of this year when it was originally scheduled to be implemented.

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Here we go with more scary blah-blah-blah on Obamacare implementation. Much of the ICD-10 standard is designed to meet _international_ coding requirements. Hence the explosion in the number of codes. These will have a minimal effect on the front office of your primary care physician, who is unlikely to be involved in treatment of a snakebite in Tanzania. The basic few hundred codes used by the typical physician will remain unchanged.

ICD coding in any form is tedious, difficult, and complicating the process makes it easier for claims to be denied. The rapidly-growing industry of Direct Primary Care, where employers and consumers reimburses primary care practices directly at low cost, does not require insurance, and hence, ICD coding. Instead, doctors concentrate on patient care.

oh no ! Doctors actually spending time with a Patient and finding out what happened to them or discover why they are hurting ? We can’t Doctors telling Patients their back problems and knee joint pain are the cause of those extremely painful shoulders. If the Doctors tell them to start sleeping on their backs with legs elevated all their pain levels will drop fast and they might not need many pain killers. Drug Companies will not like that.

This has very little to do with doctors and more to do with new software. The existing coders can look up the codes and enter them from the doctors notes BUT the software codes have to be in the system. Everyone knows that when you have no choice but to buy something people will charge you out the nose to pay for it. The bigger problem will be how many doctors just retire before they are forced to implement it. We are already seeing doctors either joining a hospital or banding into groups to consolidate costs and skills so this will probably just lead to more of that also. Banding together will allow many doctors to share software and coders so I wouldn’t worry too much about it.

Ah, they do. This is about billing codes like E993.8: “unintentional explosion of own autocannons.” or V91.07XA, “burn due to water-skis on fire, initial encounter”. The doctors know what to do to help people, it’s the government wanting to fiddle and categorize every possible method of death and dismemberment that’s bogging the system. The sad part is that instead of Dr.’s reading and keeping up with what’s important like new research, the will spend their time sorting through needless crap like this.